Abstract Purpose Normal weight obesity (NWO) is a phenotype characterised by a normal body mass index (BMI) combined with excessive body fat percentage, which poses health risks that cannot be detected by conventional BMI assessment. This study investigated the prevalence of NWO in young adults and examined associations with body composition parameters and lifestyle factors. Methods The sample comprised 833 Slovaks, men and women, aged 18–30 years (21.69 ± 2.49). Body composition was determined using InBody 770. NWO was defined as a body fat percentage of > 28% in women and > 20% in men with a BMI of ≤ 25 kg/m 2 . Lifestyle factors, assessed using a WHO-validated questionnaire, were analysed using binary logistic regression to identify predictors of NWO. Results The prevalence of NWO was significantly higher in women (31.5%) than in men (19.0%; p = 0.003). In both sexes, individuals with NWO had significantly higher visceral fat area and lower lean body mass in specific body segments than normal weight (NW) counterparts. In addition, men in the NWO group had also a significantly lower phase angle (p = 0.017). In terms of lifestyle, we found that participants who did not eat breakfast regularly had a significantly higher risk of developing NWO. Participants with the highest physical activity (> 3 times per week) showed the strongest association with NW. Conclusion NWO is relatively common in young adults, and is associated with higher visceral fat area and lower lean body mass despite a normal BMI. These findings emphasise the importance of looking beyond BMI when assessing health risks in young adults.
Falbová et al. (2025) studied this question.